Bluegrass Care Navigators - Annual Report (2021)

Liz Fowler, President & CEO Bluegrass Care Navigators

While the pandemic caused continued uncertainty, 2021 was a year of resolve at Bluegrass Care Navigators. Our team members were resolute in their commitment to providing compassionate, holistic care to all who need services that only Bluegrass Care Navigators provide. As an organization, we were committed to demonstrating how much we value our team members by curating a culture of gratitude, respect and teamwork. And once again, we did not waiver in our eagerness to foster innovative programs and operational efficiencies to improve our care.

For our patients, we:

• Launched a dementia program with funding from the federal grant awarded in 2020.

• Began BCN’s participation in the HEAL program in conjunction with the University of Kentucky, supporting patients in recovery with opioid misuse.

• Provided integrative medicine therapies to veterans and purchased virtual reality goggles to bring honor flight experiences to veteran patients, through grant funding from the Disabled Veterans National Foundation.

• Launched a palliative care clinic in Scott County through Georgetown Community Hospital’s oncology clinic.

For our team members, we:

• Began the Compassion Fund to support team members through personal hardships with direct financial support.

• Developed a Code Lavender® program to rapidly respond to team members after a traumatic or stressful patient care experience.

• Became official members of the Schwartz Center for Compassionate Healthcare© and held our first two

sessions of Schwartz rounds for team members.

• Improved wages and benefits for many of our team members, including increased hourly wages, increased minimum PTO hours, a formal remote work policy, and expanded bereavement leave.

• Hired a diversity, equity and inclusion officer to begin the foundational work to reach more diverse communities with our care and our workforce.

As an organization, we:

• Earned the Hospice Quality Connections program through NHPCO and earned first place for NHPCO’s quality award in the hospice operations division.

• Earned Hospice Honors for patient experience for all service areas through our CAHPS® Survey vendor HEALTHCAREfirst.

• Earned a top 10 placement in Kentucky’s Best Places to Work in 2021.

That’s quite the list – and it doesn’t even begin to capture the many meaningful projects that so many teammates contributed to in 2021.

I am so proud of how we have continued to navigate the pandemic by living our values, keeping our focus on our patients and families, and supporting each other through good and difficult times.

As we enter 2022, I am confident that no matter what this year brings, TeamBCN will continue to expand our compassionate care, remain a Best Place to Work in KY and be known for our teamwork and excellent healthcare services!

2021 Board of Directors

Richard Hopgood Chair

David Brennen

Vice Chair

David Fogg

Secretary

Zachary Moore

Treasurer

Liz Fowler

MPH, President & CEO

Shannon Arvin

Past Chair

John Austin

Jim Blancet

Anne Bolton

Jenna Canning Bo Cofield

Laura Feltner

Steve Fryman

Amanda Henson

Katie LaMonica

Rhonda Love

Steve Matherly

Nana Mensah

Ellen Miller

Greg Milward

Zachary Murray

Ron Ring

Robert Rosenstein

David Royse

2021 Senior Leadership Team

Liz Fowler

MPH, President & CEO

Todd Coté

MD, HMDC, FAAFP, FAAHPM, Chief Medical Officer

Croswell Chambers

Chief Information & Security Officer

Amy Doane MHA, Vice President of Marketing

Stephanie Greene

MHA, Vice President & Chief Hospice Officer

Holly Hodge

CPA, MBA, Chief Financial Officer & Vice President of Finance

Cassie Mitchell

MSN, MBA, RN, Chief Operating Officer, Clinical Services

Danita Ross

SPHR, SHRM‑SCP, Vice President of Human Resources

Eugenia Smither

BS, RN, CHP, CHE, CHC, Corporate Compliance Officer & Vice President of Compliance & Quality Improvement (CQI)

Laura Klumb

Vice President of Philanthropy

Turner West

MPH, MT, Assistant Vice President of Health Policy and Director of Palliative Care Leadership Center

Bluegrass Care Navigators Earns Top Healthcare Workplace Designation in 2021

Bluegrass Care Navigators was named the top-ranked healthcare provider among the 2021 list of 100 Best Places to work in Kentucky, as designated by the Kentucky Chamber of Commerce, the Kentucky Society for Human Resource Management and ClearPath Mutual Insurance Company.

In addition, the organization ranked in the top 10 overall among entities in the large company category with more than 500 employees. The selection process, managed by Best Companies Group, is based on an assessment of the company’s employee policies and procedures and the results of an internal employee survey.

“Our work does not happen without the dedication of a team who lives our values every day, for every patient,” said CEO Liz Fowler. “We have earned this designation because our team has built a culture of compassion, respect, dignity and teamwork.”

The employee survey covers many factors of workplace satisfaction including leadership and planning, relationships with supervisors, work environment, corporate culture and communication, role satisfaction, training and development, and pay and benefits.

“Feedback from our team is critically important to our organization’s success,” said Vice President of Human Resources Danita Ross. “We already are planning for what is important to our team as we move through the end of the pandemic. We want to know what their priorities are, what they need to feel successful at work and what brings them satisfaction in their careers.”

2021 All Service Line Totals 14,604 Total Patients Served

Hospice Care: 6,631

Transitional Care: 2,700

Palliative Care: 3,080

Home Primary Care: 1,434

Grief Care: 688

Extra Care: 71

2021 Total Income = $83,710,297

Patient Revenue: $66,763,830

Investment: $9,434,028

Philanthropy: $6,041,915

Other Income: $1,470,524

Total Expenses =

Patient Services: $62,451,156

Admin & Programs: $14,322,066

Fundraising: $679,777

2021 Hospice Care Admissions by Location

5,941 Total Hospice Care Admissions

Hazard: 840

Barbourville: 703

Frankfort: 675

Northern Kentucky: 498 Cynthiana: 518

Pikeville: 493

2021 Palliative Care Location of Service

14,402 Total Palliative Care Visits

Lexington: 2,214

Hospital: 8,194

Nursing Facility: 1,165 Primary Care (including the Willows facilities): 3,477

Palliative Home: 1,566

Highlights from Our Care in 2021

Creating a Bright Path for Families

Wylie was diagnosed with Trisomy 18, a life-threatening chromosomal disorder that can cause serious developmental issues leading to various medical complications, causing Wylie to come home with a feeding tube and also develop heart failure within her first few months. Her next six months were spent with a care team from Bluegrass Hospice Care, who helped her family obtain the necessary medical equipment and navigate through many challenges. “Something that was really special at the end of her six months with hospice was that Wylie turned one, which is a very big deal with her diagnosis,” said Wylie’s mom, Karla. “Our hospice team helped coordinate with a team in Florida, so that we could take Wylie to our vacation spots for her first-year birthday celebration, which was so wonderful and special.”

Having reached this huge milestone, Wylie made the transition from hospice to our Bright Path program, a pediatric palliative care program that provides specialized medical care for infants, children, adolescents and young adults who are living with a serious illness. “One of the first things that the Bright Path team helped us figure out was in-home nursing for Wylie. It has been so helpful having a nurse provide care for Wylie at home,” Karla said. “Without those nurses giving us some respite, it would have been really hard.”

Using a collaboration of care model, our Bright Path care team works with families to make a plan of care, identifying and treating symptoms, medication management, establishing goals of care and implementation,

and fostering spiritual support and counseling. “Bright Path helped connect us with Pediatric Home Service who provides us with durable medical equipment. It’s been huge for us, and they have even shared tips on how to prime the pump faster, and about water traps in her oxygen line,” Karla said.

Our goal with Bright Path is to improve the quality of life of the family, by providing comfort to the child while building confidence with the caregiver through education and support.

transitioned to Bright Path, there was something that shifted in my heart, and it was big. ‘Okay. We are not preparing for Wylie’s death, she is not dying, she’s living,’ and to have a group that supports life with your child with an unknown future, I hope that people would be able to see that it is huge.”

BCN had 43 Bright Path Patients IN 2021

During her time with Bright Path, Wylie has been able to experience the benefits of integrative medicine through our music therapy group, a six-week program designed specifically for Bright Path families. “I realized that Wylie hadn’t ever had that experience, nor the aspect of being with other kids her age. She loved it and loved music. I loved it and loved being able to see the other families. It was virtual, but even without COVID, I’m not sure many other families would have been able to bring their children to an actual facility.” Bright Path also offers a support group specific for caregivers that Karla has participated in, focusing on coping with having a child with medically complex special needs. Karla shares, “We went through all these different ways of relieving stress. And it has continued to be really lifegiving and helpful.” Bright Path families have access to our care team through a 24-hour call center for support and guidance. “We just have this general sense of knowing, like if we needed anything—if we were having trouble with anything - we could call Bright Path and it would be welcome,” Karla said. “I always have the sense when they ask, ‘What do you need? What can we do?’, that it’s so genuine. That gives us such wonderful reassurance.”

Bright Path provided Karla and her family a new outlook on life: “I remember, right before we

With the help of Bright Path, Wylie has been able to be at home with no hospital admissions or outside appointments. “She’s growing and learning and developing. When you think your child is dying, you sit beside them, and you wonder are we going to wake up today. But when you begin living, you shift your energies a little bit, and your focus,” Karla said, “And to those who’ve supported us, thank you is always too small. Your donation is not just helping the individual with the medical need, but the family—my whole family.”

Bluegrass Care Navigators Now Offers Palliative Care in Georgetown

Bluegrass Care Navigators expanded palliative care services to Scott County, providing services to oncology patients at Georgetown Community Hospital through the Georgetown Cancer Care clinic.

Palliative care is specialized, holistic medical care for people living with serious illness, focused on providing relief from symptoms and stresses with the goal of improving quality of life for the patient and their families. This supportive care model can help manage complaints such as nausea, pain, shortness of breath, anxiety, weakness, fatigue, gastrointestinal discomforts and much more.

BCN had 3,080 Palliative Care Patients IN 2021

Oncology patients at Georgetown Cancer Care Clinic are referred to the Bluegrass Care Navigator’s palliative care team by their oncologist. The palliative care doctor and nurse, and oncologist work together to manage the patient’s needs. Palliative care is available to patients as they continue curative treatments for their cancer diagnosis.

“Palliative care provides an extra layer of support to the patient, their family and their oncology care team” said Bluegrass Care Navigators physician Dr. Liz Markus. “We stay focused on keeping the patient’s symptoms in check, so the patient and their oncologist can focus on treating their cancer.”

“This new partnership allows us to have Bluegrass Care Navigator’s palliative care providers embedded into our cancer care clinic, which enhances the quality of care we can provide at Georgetown Community Hospital,” said Kent Taylor, MD.

BCN

Celebrates Anniversaries of the Greg and Noreen

Wells Bluegrass Hospice Care Center, Saint Joseph Hospital and Cynthiana Regional Office

In May 2021, Bluegrass Care Navigators celebrated the 10-year anniversary of the Greg and Noreen Wells Bluegrass Hospice Care Center in Hazard. Since its opening in 2011, more than 3,500 patients have benefitted from this inpatient facility for hospice care.

Greg and Noreen Wells Hospice Care Center

In the same year, Bluegrass Care Navigators celebrated the 25th anniversary of the Hospice Care Center at Saint Joseph Hospital in Lexington in August. Since 1996, patients and their families have benefited from this dedicated hospital space for hospice care.

The hospice care centers provide a comforting place for patients and families when symptoms cannot be controlled in the home, or the family is unable to provide the care that is needed for a loved one at home. The centers enable families to remain involved in the patient’s care while benefiting from the full-time nursing and physician services.

In 2011, Bluegrass Care Navigators was honored to receive a lead gift for the hospice care center in Hazard. Today, the Greg and Noreen Wells Bluegrass Hospice Care Center provides end-of-life and respite care for patients who struggle to manage symptoms at home, in a setting designed to comfort both the patient and their loved ones.

“We are proud to celebrate 10 remarkable years made possible by the generosity of Greg and Noreen Wells. We look forward to providing many more years of service to patients and families,” said Monica Couch, Associate Vice President of Eastern Kentucky Operations for Bluegrass Care Navigators.

Located in Hazard to serve southeastern Kentucky, the hospice care center features 12 private patient suites with outdoor patios, and multiple family areas. The Bluegrass Hospice Care Center at Saint Joseph Hospital is located in Lexington, serving patients in centeral Kentucky. This 12-bed unit is housed inside the hospital and features private, spacious rooms as well. Each care center is equipped to manage more serious care needs, while allowing patients to spend quality time with loved ones.

Specially trained team members and volunteers carry out a patient-focused plan of care developed by the hospice team in collaboration with the patient, family and attending physician. Both patients and families can receive emotional and spiritual support from Bluegrass Care Navigators' social workers and chaplains.

Inpatient hospice care made a difference for Peg and Gordon Munson and their daughter, Donna, in 2005. “I had never had a hospice experience before this, and I could not believe all that the hospice team does and provides to the patients and family members,” Peg reflected. “They really got our entire family through a very difficult time. It brings tears to my eyes to remember the care that was given to us.” Out of appreciation for the extraordinary care they received, the Munsons have continued to provide annual support to the Bluegrass Hospice Care Center at Saint Joseph Hospital in memory of their daughter.

“Everyone deserves compassionate and expert care when facing a serious illness,” said Stephanie Greene, Chief Hospice Officer for Bluegrass Care Navigators. “Our care center allows us to extend that opportunity to patients who are unable to be cared for at home.”

30 Years of Caring in Cynthiana

In November, Bluegrass Care Navigators celebrated its 30th anniversary of providing hospice care to Nicholas, Bourbon, Scott and Harrison counties.

In 1978, a group of volunteers began a hospice service in Lexington. After growing into then-named Hospice of the Bluegrass throughout the 1980s, the nonprofit expanded north and began providing care in Harrison and surrounding counties.

Bluegrass Care Navigators provides hospice care to approximately 500 families in the region each year. In addition, the organization provides free grief care services to anyone in the community who needs support after a loss.

The services provided by Bluegrass Care Navigators from the Cynthiana regional office are made possible by more than 50 local clinical and administrative team members and 40 local volunteers.

“We are humbled and proud to have served this community for three decades,” said Executive Director Amy Cox. “Many of our nurses have worked for Bluegrass Care Navigators almost as long as this regional office has been in existence, and it is an honor to provide compassionate care to our patients in their home, or with our nursing home and hospital partners.”

Volunteer Delivers Compassion to Hospice Patients

By Pete Croswell, September 2021

In March of 2020, Frankfort Volunteer Coordinator Jennifer Hubbard asked me if I would take on a mission for hospice patients something to augment our volunteer support, especially since the COVID pandemic curtailed a lot of our volunteer services. This mission is to deliver “Compassion Bags” to family and caregivers of recently deceased patients in our four-county area (Franklin, Anderson, Woodford and Owen). So without too much hesitation, I took that on and have been doing it since April 2020. These Compassion Bags are one way we do outreach and connect with families and caregivers after a loss and show our support. The standard items provided include a picture frame and insert, forget-me-not seed packet, candle, flyers and kids' items when young children are involved. Early on, I decided that the bags need a few more items so I get additional things: night light, healthy snack, lip balm or hand sanitizer.

I guess I’ve done about 600 of these, but I’ve lost count. I don’t keep track since I destroy the records after delivery. Jennifer and I organize the deliveries with a list and map, and I always call prior to a visit. I think I’ve seen about every city street and country road in the region. In the majority of cases, I have the opportunity to talk with the person on the phone and/or at the front door (with mask and distance). Mainly, I listen but try to say some comforting words and indicate our ongoing support for family members and caregivers. In some cases, there is information I convey to the Frankfort regional office if necessary. I need to mention also that my wife Ann has been a big help organizing/filling the bags, and she is in the process of becoming a Bluegrass Care Navigators volunteer so she can help me with the deliveries and make sure I don’t get lost—even with mobile navigation tools that still happens out in the rural areas.

Something all volunteers and team members can relate to is that encountering cases of death—even indirectly can be hard sometimes, but I believe this does make a difference to people who are dealing with grief and challenges—knowing there is support and others thinking about them really does help. I know this because they tell me. The majority of the time, those I visit express extreme satisfaction and appreciation for the services they have received from the team members. Can’t say I have ever worked with an organization with that amount of consistent, positive feedback. So, this is a paton-the-back for all administrative people, medical personnel, social workers, chaplains and volunteers who provide the support.

One other thing. We live in a situation today with a lot of division in terms of politics, religion, race, economics, etc., and too often this comes out in a negative way. Too much focus on what makes us different than things that should bring us together. But when I go out with that badge and extend help and support, regardless of who the person is, those divisions disappear—at least that is my experience with those I have interacted with.

Ann and Pete Crowell with Compassion Bags.

BCN had 9,810 Volunteer Hours IN 2021

Bluegrass Care Navigators Launches Schwartz Rounds

Bluegrass Care Navigators has joined an evidenced-based program for its employees to openly and honestly discuss the most challenging emotional and social issues they face in caring for patients and families. The Schwartz Rounds® program has been found to enhance compassionate care, improve teamwork and reduce caregiver stress.

Schwartz Rounds are common in hospital settings, but Bluegrass Care Navigators was the first among hospice providers in the nation to join the program.

Schwartz Rounds are a program of the Schwartz Center for Compassionate Healthcare, a national nonprofit dedicated to putting compassion at the heart of healthcare through programs, education and advocacy. In contrast to traditional medical rounds, the focus of Schwartz Rounds is on the human dimension of medicine. Healthcare professionals have an opportunity to share their experiences, thoughts and feelings on thoughtprovoking topics drawn from actual patient cases. The goal is for healthcare professionals to make personal connections with patients and colleagues because they have greater insight into their own responses and feelings.

“Our team is called to exhibit a tremendous capacity for compassion and respect as we care for patients with chronic illness or at the end of life,” said Lindsay Kampfer, Counseling Resource Officer for Bluegrass Care Navigators. “We spend much of our practice supporting patients and families through their emotional and spiritual needs. Schwartz Rounds will give our team an intentional, clinically-driven program to make space for their own emotions and experiences.”

Studies have shown that 90 percent of caregivers who attended multiple Schwartz Rounds reported better communication with their co-workers, and 86 percent reported feeling more compassionate toward patients and families.

Schwartz Rounds were first piloted at Massachusetts General Hospital in Boston in 1997. Since then, the program has grown rapidly as the need has increased. Today, more than 500 sites across the U.S., Canada, Australia and New Zealand are Schwartz Center members and conduct the Rounds program, with another 200+ sites running the program through a partnership in the U.K. and Ireland.

BCN Receives Grant Award from Disabled Veterans National Foundation

In 2021, Bluegrass Care Navigators provided integrative medicine therapies to disabled Veterans in Kentucky through a grant of $15,000 from the Disabled Veterans National Foundation (DVNF).

Using music, art and massage therapies, Bluegrass Care Navigators helped Veterans alleviate stress, reduce pain and process emotions. The organization also used grant funding to participate in a virtual reality program that gives veterans who cannot travel the opportunity to experience honor flights to national military monuments in Washington, D.C. Additionally, Bluegrass Care Navigators expanded partnerships with Veterans’ organizations in Kentucky, and developed our clinicians’ expertise in providing compassionate care to our Veteran patients.

“Bluegrass Care Navigators serves more than 1,000 Veterans each year in hospice and palliative care,” said CEO Liz Fowler. “We are so honored to partner with DVNF through this grant to provide therapies focused on disabled Veterans in Kentucky.”

Joseph VanFonda (USMC) SgtMaj. Ret., CEO of the Disabled Veterans National Foundation said, “We are very proud to support Bluegrass Care Navigators as they continue to make a positive impact in Veteran’s lives with integrated medicine therapies. We would like to congratulate and thank them for their commitment and continued service and program assistance for the men and women who served in the defense of our country.”

Disabled Veterans cared for by Bluegrass Care Navigators are offered integrative medicine therapies through their care team.

Transitional Care Team Helps Elderly Mom and Daughter

It was the first visit to assess a new patient. Jane was an elderly lady with dementia. She lived with her daughter, who was her caregiver – and was also elderly.

As the social worker entered the home, she could hear Jane crying out in pain. She was lying in bed in a fetal position, unable to move because the pain was too intense. Her daughter was distraught. She had called 9-1-1 after her mother had taken a fall. Jane refused to allow the EMS to take her to the hospital. She was at a loss as to how to help her mother, and the EMS recommended she call our Bluegrass Transitional Care Dementia Program.

The Bluegrass Transitional Care Dementia program typically helps patients make the move from hospital to home easier and safer, helping to ensure that the patient will have the resources and care they need at home to recover and to avoid another hospitalization. But sometimes, transitional care takes a different path, unique to the patient’s individualized care needs.

We received a three-year, $1 million grant to care for those with Alzheimer’s and related dementias and to provide resources to help caregivers manage the long-term demands of caregiving. This grant is funded by the Administration for Community Living/Administration on Aging under the U.S. Department of Health and Human Services. A major goal of this free program is helping both patients and their caregivers enjoy a better quality of life. Bluegrass Care Navigators is one of only 13 organizations in the nation awarded the grant and the only one in Kentucky. We are currently serving more than 30 counties throughout Kentucky and continuing to expand.

Concerned about the patient’s immediate need for medical care, the social worker called the local EMS and was able to coordinate care between the patient, her daughter and the EMS to get her transported to the emergency room where she received the care she needed.

“We assess the needs of each individual, and we connect them to services in the community such as meal delivery, equipment and transportation to doctor visits,” says Jamie Cody, Transitional Care supervisor.

But often, like in this case, the transition isn’t only about moving location or coordinating care. It’s about transitioning the way we think about caregiving, how we apply caregiving, how we adjust to the ever-changing needs of both the patient and the caregiver.

BCN had 39 Transitional Care Patients IN 2021

And for families living with dementia, these transitions can be truly overwhelming.

Jane’s daughter was feeling hopeless, helpless, and guilt-ridden at the thought of not being able to care for her mother in their home like she once could. With the social worker’s help and understanding, the daughter realized her mother now needed a higher level of care than she could provide and, together, they coordinated Jane’s transition from home to a long-term care facility.

Their social worker recalls how she felt that day: “I couldn’t leave without doing something...and know that Jane would be safe – that they both would have the care they need. Tonight reminded me why I became a social worker. I cried when I got in my car. This is what God meant me to do.”